NSG 552 EXAM QUESTIONS & VALID
CORRECT ANSWERS PASSED
LATEST VERSION
Naloxone (Narcan) - Correct Answer ✔✔ opioid antagonist
Narcan - Correct Answer ✔✔ Treatment of choice for opiate overdose
It is prescribed routinely for all patients with opiate use disorder
Very short half-life
Methadone - Correct Answer ✔✔ Long acting full opioid receptor agonist at mu receptor
Restricted use to abuse trx facilities
Monitor for QTC prolongation(cardiac abnormalities
Suboxone - Correct Answer ✔✔ Opiod agonist/ antagonist
Decreased cravings
Can precipitate withdrawals if used too soon after full opioid agonist-it will displace any
residual opioids from the mu receptors
Sublingual preparation that is safer
Waiver needed to prescribe outpatient
Useful for patients with opiate use disorder with comorbid pain
Suboxone can be used in pain management
Naltrexone - Correct Answer ✔✔ competitive opiod antagonist
Precipitate withdrawal if used within 7 days of heroine use
Available orally or monthly depot injections
Treatment of choice for highly motivated patients
Risk for LFT elevation
Opoid(Heroin) - Correct Answer ✔✔ Intoxication: miosis, hypotension, bradycardia, Low
RR, unconscious
Trx: Naloxone
Withdrawal: Anxiety, lacrimation, muscle aches, abdominal cramps and diarrhea,
seizures
Mgt: Buprenorphine/naloxone, clonidine, Bentyl
It is more effective at suppressing and controlling withdrawal than methadone
Cocaine - Correct Answer ✔✔ Intoxication: Auditiory hallucinations, agitation, violent
behavior, muscle twitching, HTN, Tachycardia
Txt: Lorazepam
Withdrawal: Antabuse use in cocaine use d/o= increases dopamine in the brain reward
circuit and act as an agonist trx in the setting of cocaine use d/o
, Cocaine induced chest pain and MI - Correct Answer ✔✔ Txt: Nitoglycerin, Aspirin
No Metoprolol
Beta blockers are contraindicated in patients with cocaine induced chest pain-lowers
coronary blood flow thereby worsening ischemia
Alcohol intoxication - Correct Answer ✔✔ Impaired fine motor control
Impaired judgment and coordination
Ataxic gait and poor balance
Lethargic, difficulty sitting upright, difficulty with memory
Nausea/Vomiting
Coma=Levels 300mg/dl and over
Respiratory depression and death possible
Alchohol withdrawal - Correct Answer ✔✔ Mild: Insomnia, irritability, Hand tremor
Moderate: Autonomic hyperactivity(diaphoresis, tachy, HTN), HTN
Severe: Seizures(12-48 hours consumption); hallucinations; delium tremens(48-96 hrs
after last drink)
Anxiety
Anorexia
Nausea/Vomiting
Psychomotor agitation
Use CIWA to monitor withdrawal
CIWA protocol - Correct Answer ✔✔ Area assessed: nausea/Vomiting, Tremor,
paroxysmal sweats, anxiety, agitation, tactile disturbances, auditory disturbances, visual
disturbances, HA, orientation
CIWA scoring and what it means
less than 10=mild
10-15: moderate
15+=Severe
Naltrexone - Correct Answer ✔✔ Opiod receptor antagonist
Can be used for both ETOH and Opioid Use d/o
Reduces desires/cravings
1st Trx: PO/IM
Will precipitate withdrawal in patients with physical opioid dependence
Acamprosate (Campral) - Correct Answer ✔✔ Likely modulates glutamate transmission
First line trx in maintaining abstinence after detox
Used for relapse prevention(post detoxification)
Can be used in liver disease-not metabolized by liver
Can be administered to patients with hepatitis, liver dz and those who continue to drink
alcohol
Contraindicated in severe renal disease
Decreases craving
CORRECT ANSWERS PASSED
LATEST VERSION
Naloxone (Narcan) - Correct Answer ✔✔ opioid antagonist
Narcan - Correct Answer ✔✔ Treatment of choice for opiate overdose
It is prescribed routinely for all patients with opiate use disorder
Very short half-life
Methadone - Correct Answer ✔✔ Long acting full opioid receptor agonist at mu receptor
Restricted use to abuse trx facilities
Monitor for QTC prolongation(cardiac abnormalities
Suboxone - Correct Answer ✔✔ Opiod agonist/ antagonist
Decreased cravings
Can precipitate withdrawals if used too soon after full opioid agonist-it will displace any
residual opioids from the mu receptors
Sublingual preparation that is safer
Waiver needed to prescribe outpatient
Useful for patients with opiate use disorder with comorbid pain
Suboxone can be used in pain management
Naltrexone - Correct Answer ✔✔ competitive opiod antagonist
Precipitate withdrawal if used within 7 days of heroine use
Available orally or monthly depot injections
Treatment of choice for highly motivated patients
Risk for LFT elevation
Opoid(Heroin) - Correct Answer ✔✔ Intoxication: miosis, hypotension, bradycardia, Low
RR, unconscious
Trx: Naloxone
Withdrawal: Anxiety, lacrimation, muscle aches, abdominal cramps and diarrhea,
seizures
Mgt: Buprenorphine/naloxone, clonidine, Bentyl
It is more effective at suppressing and controlling withdrawal than methadone
Cocaine - Correct Answer ✔✔ Intoxication: Auditiory hallucinations, agitation, violent
behavior, muscle twitching, HTN, Tachycardia
Txt: Lorazepam
Withdrawal: Antabuse use in cocaine use d/o= increases dopamine in the brain reward
circuit and act as an agonist trx in the setting of cocaine use d/o
, Cocaine induced chest pain and MI - Correct Answer ✔✔ Txt: Nitoglycerin, Aspirin
No Metoprolol
Beta blockers are contraindicated in patients with cocaine induced chest pain-lowers
coronary blood flow thereby worsening ischemia
Alcohol intoxication - Correct Answer ✔✔ Impaired fine motor control
Impaired judgment and coordination
Ataxic gait and poor balance
Lethargic, difficulty sitting upright, difficulty with memory
Nausea/Vomiting
Coma=Levels 300mg/dl and over
Respiratory depression and death possible
Alchohol withdrawal - Correct Answer ✔✔ Mild: Insomnia, irritability, Hand tremor
Moderate: Autonomic hyperactivity(diaphoresis, tachy, HTN), HTN
Severe: Seizures(12-48 hours consumption); hallucinations; delium tremens(48-96 hrs
after last drink)
Anxiety
Anorexia
Nausea/Vomiting
Psychomotor agitation
Use CIWA to monitor withdrawal
CIWA protocol - Correct Answer ✔✔ Area assessed: nausea/Vomiting, Tremor,
paroxysmal sweats, anxiety, agitation, tactile disturbances, auditory disturbances, visual
disturbances, HA, orientation
CIWA scoring and what it means
less than 10=mild
10-15: moderate
15+=Severe
Naltrexone - Correct Answer ✔✔ Opiod receptor antagonist
Can be used for both ETOH and Opioid Use d/o
Reduces desires/cravings
1st Trx: PO/IM
Will precipitate withdrawal in patients with physical opioid dependence
Acamprosate (Campral) - Correct Answer ✔✔ Likely modulates glutamate transmission
First line trx in maintaining abstinence after detox
Used for relapse prevention(post detoxification)
Can be used in liver disease-not metabolized by liver
Can be administered to patients with hepatitis, liver dz and those who continue to drink
alcohol
Contraindicated in severe renal disease
Decreases craving
